Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Ischemic Heart Disease
Association Between J-Point Elevation and Death From Coronary Artery Disease
– 15-Year Follow-up of the NIPPON DATA90 –
Takashi HisamatsuTakayoshi OhkuboKatsuyuki MiuraTakashi YamamotoAkira FujiyoshiNaoko MiyagawaAya KadotaNaoyuki TakashimaShin-ya NagasawaYoshikuni KitaYoshitaka MurakamiAkira OkayamaMinoru HorieTomonori OkamuraHirotsugu Ueshimafor the NIPPON DATA90 Research Group
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Supplementary material

2013 Volume 77 Issue 5 Pages 1260-1266


Background: An early repolarization pattern, characterized by an elevation of the QRS-ST junction (J-point) on 12-lead electrocardiography (ECG) is associated with cardiac and sudden death. However, little is known about the prognostic significance of J-point elevation for various disease-specific cardiovascular outcomes, including coronary artery disease (CAD). Methods and Results: To investigate the association between the presence of J-point elevation ≥0.1mV and various disease-specific cardiovascular outcomes, we conducted a 15-year prospective study in a representative general Japanese population of 7,630 individuals (41% men, mean age 52.4 years) who participated in the National Survey of Circulatory Disorders. Cox models were used to estimate the hazard ratios (HRs) adjusted for possible confounding factors. J-point elevation was present in 264 individuals (3.5%) and was associated with an increased risk of cardiac death (adjusted HR, 2.54; 95% confidence interval [CI] 1.40–4.58; P=0.002) and death from CAD (adjusted HR, 4.66; 95% CI 2.30–9.46; P<0.001). In a subgroup analysis by age, the association between J-point elevation and cardiovascular outcomes was more remarkable in middle-aged (<60 years) than in older individuals (≥60 years) (all P for interaction <0.05). Conclusions: J-point elevation on standard 12-lead ECG was an independent predictor of cardiac death and death from CAD in a representative sample of the general Japanese population, particularly among the middle-aged.  (Circ J 2013; 77: 1260–1266)

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